One common question associated with workplace injuries is why an injured worker cannot sue an employer for negligence in causing the injury. In most states, employers are immune from negligence claims brought by an employee of the company. This rule, which also bars suits against co-workers, dates back to the enactment of workers’ comp laws in the early 1900’s. Before that time, if a worker was injured on the job due to the negligence of the employer, he or she could sue for the full range of personal injury damages, including pain, suffering, lost income, medical bills and permanent impairment. While that sounds good in theory, that approach is very hard on injured workers and their families. First, personal injury cases cannot be settled until healing is complete, and that can take many months – years in serious cases. Injured workers cannot afford to wait to have their medical bills paid or to have an income. Second, personal injury claims filed in court are fault-based claims—the injured person must prove that the defendant’s carelessness caused the injury. In some work injury situations, it is not possible to prove that the injury was caused by the fault of the employer. Such conditions as gradual injuries from repetitive motion, back injuries caused by lifting, lung infections caused by exposure to wool, cotton or chemicals, and crush injuries caused by defective machines may not result from fault on the part of the employer. Under a fault-based system, an injured worker might not be compensated at all in those cases. The workers’ compensation system became law based on a compromise which provides that the injured employee will get paid quickly and regardless of fault but in exchange must give up the right to sue the employer.
Coordination of benefits
People who are injured at work may have several different remedies available to them. First, workers’ compensation benefits are intended to cover wage loss and necessary medical treatment. If the injury is a serious one likely to cause disability that will last for twelve months or more, Social Security may provide disability benefits and medical bill payments through Medicare. If the injury occurs in circumstances where a third party is legally responsible (at fault), a personal injury suit or settlement may result in an award of damages for lost wages, medical benefits, pain, suffering, and permanent loss of use or function of a limb or joint. Finally, there may be private insurance available to contribute toward loss of earnings and medical bills.
In cases where more than one of these sources of recovery may be available, some form of “coordination of benefits” is usually required because the law generally prohibits a person from “collecting twice” for the same injury. For example, someone who is eligible for both workers’ comp and Social Security disability benefits will probably not get the full of amount of benefits from both sources. In most cases, Social Security benefits are reduced in consideration of the receipt of workers’ comp benefits; as workers’ comp benefits go up, Social Security benefits go down. If an injured person receives workers’ comp benefits and also wins a car accident case related to the same injuries, the workers’ comp carrier is likely to be entitled to be paid back from the proceeds of the auto accident case. Whether these results are fair or not, they are the consequences of the basic “cannot collect twice” policy in the law.
Part of an attorney’s job in advising a client about settlement of an injury case is to consider what effect a settlement of one part of the case may have on other benefits. Will settlement of a workers’ compensation case result in more or less Social Security benefits? Can the settlement of a workers’ compensation case be coordinated with the settlement of a related product defect case so that effect of the “payback” provisions in the comp law will not be quite so onerous?
Every case and every client’s needs are different. If you have questions about employer negligence, coordination of benefits, or other details related to a workplace injury, please call us, email us, or reach us through our website bermansimmons.wpengine.com. At Berman and Simmons, you will be connected to an attorney who will answer your preliminary questions without charge. If we are able to help you, we will take your case on a contingent fee basis, which means we are only paid when you win.